Diabetic Foot

Diabetic foot is one of the major complications of diabetes mellitus. Diabetics are prone to foot ulcerations due to both neurological and vascular complications.

In conventional system of medicine or allopathic line of treatment there are oral pain medications and antibiotics to relieve pain and prevent infection and if the condition is worse i.e when deeper tissues like bone are involved (gangrene), then surgical removal of the limb (amputation) is the treatment of choice to prevent disease process in the body.

Treatment in homeopathic system of medicine is aimed to reduce intensity of symptoms and further infection in the most natural way. Medicines and local application work wonders in healing wounds post surgery as well as in cases of diabetic foot and non healing ulcers.

There are several remedies available in homoeopathy which helps in healing wound and prevent amputation. Those individuals who experience pain are prescribed remedies which significantly relieve pain and burning sensation as well as remedies which reduce edema, tendonitis, and osteomyelitis and especially improve peripheral circulation.

How homeopathy helps

It helps in improving blood circulation of the affected limb.

The remedies helps in wound healing.

Treatment helps in preventing secondary infection of the wound.

It helps in reducing pain and swelling of affected limb.

There are 15 medicines which give great relief. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the homeopathy doctor. The treatment is decided after thorough case taking of the patient. Thus homoeopathic remedies of diabetic foot, ulcer, gangrene are designer made unlike allopathy in which all patients receive the same drugs although trade name may be different.

What is Diabetic Foot

A diabetic foot is a foot that exhibits pathology that results directly from diabetes mellitus or any long-term (or “chronic”) complication of diabetes mellitus.

Presence of several characteristic diabetic foot pathologies is called diabetic foot syndrome.

Diabetes mellitus (DM) causes several diseases in which high blood glucose levels over time can damage the nerves, kidneys, eyes, and blood vessels. Diabetes can also decrease the body’s ability to fight infection. When diabetes is not well controlled, damage to the organs and impairment of the immune system takes place.

Causes

Several risk factors cause chances of developing foot problems and diabetic infections in the legs and feet.

Nerve damage : People with long standing or poorly controlled diabetes are at risk for having damage to the nerves in their feet (peripheral neuropathy).

Because of the nerve damage, the patient may be unable to feel their feet normally. Also, they may be unable to sense the position of their feet and toes while walking and balancing. With normal nerves, a person can usually sense if their shoes are rubbing on the feet or if one part of the foot is becoming strained while walking.

A person with diabetes may not properly sense minor injuries (such as cuts, scrapes, blisters), signs of abnormal wear and tear (that turn into calluses and corns), and foot strain. Normally, people can feel if there is a stone in their shoe, then remove it immediately. A person who has diabetes may not be able to perceive a stone. Its constant rubbing can easily create a sore.

Poor circulation : Especially when poorly controlled, diabetes can lead to accelerated hardening of the arteries or atherosclerosis. When blood flow to injured tissues is poor, healing does not occur properly.

Trauma to the foot : Any trauma to the foot can increase the risk for a more serious problem to develop.

Infections : Athlete’s foot, a fungal infection of the skin or toenails, can lead to more serious bacterial infections and should be treated promptly.

Ingrown toenails should be handled right away by a foot specialist. Toenail fungus should also be treated.

Smoking : Smoking any form of tobacco causes damage to the small blood vessels in the feet and legs. This damage can disrupt the healing process and is a major risk factor for infections and amputations.

Symptoms

Damage to the nervous system causes a person with diabetes not able to feel his or her feet properly.

Normal sweat secretion and oil production that lubricates the skin of the foot is impaired.

These factors together can lead to abnormal pressure on the skin, bones, and joints of the foot during walking and can lead to breakdown of the skin of the foot. Sores may develop.

Damage to blood vessels and impairment of the immune system from diabetes makes it difficult to heal these wounds. Bacterial infection of the skin, connective tissues, muscles, and bones can then occur.

These infections can develop into gangrene. Because of the poor blood flow, antibiotics cannot get to the site of the infection easily. Often, the only treatment for this is amputation of the foot or leg. If the infection spreads to the bloodstream, this process can be life threatening.

Redness can be a sign of infection, especially when surrounding a wound, or of abnormal rubbing of shoes or socks.

Swelling of the feet or legs can be a sign of underlying inflammation or infection, improperly fitting shoes, or poor venous circulation. Other signs of poor circulation include the following :

Pain in the legs or buttocks that increases with walking but improves with rest

Hair no longer growing on the lower legs and feet

Hard shiny skin on the legs

Localized warmth can be a sign of infection or inflammation, perhaps from wounds that won’t heal or that heal slowly

Any break in the skin is serious and can result from abnormal wear and tear, injury, or infection.

Calluses and corns may be a sign of chronic trauma to the foot. Toenail fungus, athlete’s foot, and ingrown toenails may lead to more serious bacterial infections.

Drainage of pus from a wound is usually a sign of infection. Persistent bloody drainage is also a sign of a potentially serious foot problem.

A limp or difficulty walking can be sign of joint problems, serious infection, or improperly fitting shoes.

Fever or chills in association with a wound on the foot can be a sign of a limb threatening or life threatening infection.

Red streaking away from a wound or redness spreading out from a wound is a sign of a progressively worsening infection.

Numbness in the feet or legs can be a sign of nerve damage from diabetes, which increases a person’s risk for leg and foot problems.

Investigations

Complete blood count CBC, which will assist in determining the presence and severity of infection. A very high or very low white blood cell count suggests serious infection.

Depending upon the severity of the problem, the doctor may also order kidney function tests, blood chemistry studies (electrolytes), liver enzyme tests, and heart enzyme tests to assess whether other body systems are working properly in the phase of serious infection.

X-rays : The doctor may order x-rays studies of the feet or legs to assess for signs of damage to the bones or arthritis, damage from infection, foreign bodies in the soft tissues. Gas in the soft tissues, indicates gangrene.

Ultrasound : The doctor may order Doppler ultrasound to see the blood flow through the arteries and veins in the lower extremities. The test is not painful and involves the technician moving a non-invasive probe over the blood vessels of the lower extremities.

Angiogram : If the vascular surgeon determines that the patient has poor circulation in the lower extremities, an angiogram may be performed in preparation for surgery to improve circulation.

Self Care at Home

A person with diabetes should do the following :

Foot examination : Examine your feet daily and also after any trauma, no matter how minor, to your feet. Use a water based moisturizer every day (but not between your toes) to prevent dry skin and cracking. Wear cotton or wool socks. Avoid elastic socks and hosiery because they may impair circulation.

Eliminate obstacles : Move or remove any items you are likely to trip over or bump your feet on. Keep clutter on the floor picked up. Light the pathways used at night – indoors and outdoors.

Exercise : Regular exercise will improve bone and joint health in your feet and legs, improve circulation to your legs, and will also help to stabilize your blood sugar levels. Consult your physician prior to beginning any exercise program.

Smoking : If you smoke any form of tobacco, quitting can be one of the best things you can do to prevent problems with your feet. Smoking accelerates damage to blood vessels, especially small blood vessels leading to poor circulation, which is a major risk factor for foot infections and ultimately amputations.

Diabetes control : Following a reasonable diet, taking your medications, checking your blood sugar regularly, exercising regularly, and maintaining good communication with your physician are essential in keeping your diabetes under control. Consistent long term blood sugar control to near normal levels can greatly lower the risk of damage to your nerves, kidneys, eyes, and blood vessels.

Foot Complications

Diabetic foot ulceration. It occurs in 15% of all patients with diabetes and precedes 84% of all diabetes related lower leg amputations

Diabetic foot infections

Neuropathic osteoarthropathy of the foot

Prevention

People with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur.

Although treatment for diabetic foot problems has improved, prevention – including good control of blood sugar level – remains the best way to prevent diabetic complications.

People with diabetes should learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problems.

They should also learn what is reasonable to manage routine at home foot care, how to recognize when to call the doctor, and how to recognize when a problem has become serious enough to seek emergency treatment.